L-2036 Responses
John Craig
Description
Collection
Title:
L-2036 Responses
Creator:
John Craig
Date:
4/23/2012
Text:
Dear Listserve,
Following are responses to my recent post about Medicare Region C saying
L-2036 was a non-covered code:
1) Sounds like misinformation. I would have your office check this again. We
are unaware of any change to this L-Code coverage.
2) We have not had a problem with L2036...but is has been several months since
we sent a claim to Medicare.
3) You will find that there are many codes with a price on the fee schedule
that are not covered by Medicare.
I am told that they are there for commercial insurances that do cover the code
and want to keep the reimbursement rate at Medicare's level.
4) As far as I know, that should be covered. Check your billing modifiers.
Did you make sure to add the LT/RT and the KX if all the policy criteria is
met?
5) If the patient's ambulatory status is not CLEARLY defined with a statement
that reads something akin to, Patient ambulates independent of assistive
devices with the following gait abnormalities:____, Patient ambulates with a
cane/walker as an assistive device with the following gait abnormalities:______
your claim will likely be denied.
Following are responses to my recent post about Medicare Region C saying
L-2036 was a non-covered code:
1) Sounds like misinformation. I would have your office check this again. We
are unaware of any change to this L-Code coverage.
2) We have not had a problem with L2036...but is has been several months since
we sent a claim to Medicare.
3) You will find that there are many codes with a price on the fee schedule
that are not covered by Medicare.
I am told that they are there for commercial insurances that do cover the code
and want to keep the reimbursement rate at Medicare's level.
4) As far as I know, that should be covered. Check your billing modifiers.
Did you make sure to add the LT/RT and the KX if all the policy criteria is
met?
5) If the patient's ambulatory status is not CLEARLY defined with a statement
that reads something akin to, Patient ambulates independent of assistive
devices with the following gait abnormalities:____, Patient ambulates with a
cane/walker as an assistive device with the following gait abnormalities:______
your claim will likely be denied.
Citation
John Craig, “L-2036 Responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/233469.
